Digital Commons Network^™

A Community Oriented Solution To Access To Care, Margaret Louise Thornell

Walden Dissertations and Doctoral Studies

Access to primary health care services is a significant issue for many communities seeking to improve the health of their populations. This single case study describes the 12-year journey of 2 adjoining rural counties in 2 states towards meeting the primary and specialty care needs of the uninsured and underinsured population. Data were triangulated using historical documents, first-person interviews, and health utilization data. The community leadership moved through various models including a free clinic and a university-sponsored health center before finally establishing a federally qualified health center, which now serves 40,000 citizens in these counties. The site is now hosting …

Leader Self-Perceptions Of Ethics In And Out Of The Workplace And Personal Trustworthiness, Marcia W. Vanderwood

Walden Dissertations and Doctoral Studies

Ethical breaches in many organizations can be traced to failures in ethical leadership, which undermine trust. If a leader's ethical behavior in their private life and settings is perceived as influencing workplace ethics, it may in turn affect organizational trust levels and the development of trust. A quantitative study based on the social learning and moral theory was conducted to determine whether a difference exists between a leader's self-perceptions of their ethical behaviors inside and outside of the workplace, and whether it affects their perceived personal trustworthiness. Participants' (N = 94) scores on work and nonwork versions of the ethical …

Development Of A Clinical Nurse Leadership Orientation Program, Sunita Waddell

Walden Dissertations and Doctoral Studies

Nurses are often promoted or hired into leadership positions without the benefit of a formal orientation to their new leadership positions. The challenge of navigating the various expectations of the role of clinical nurse leader (CNL) such as fiscal ownership, staffing patterns, payroll, and disciplinary action process can be overwhelming. The lack of a formalized orientation process and an identified nurse leader to function as a mentor can contribute to the novice CNL feeling unsupported and overwhelmed. The purpose of this project was to identify, develop, and evaluate a CNL orientation manual, outline, and program for newly appointed CNLs. The …

Nurses' Perception Of Their Role In Patient Safety, Janeane Walker

Walden Dissertations and Doctoral Studies

Despite efforts to ensure patient safety in the United States, patients are being harmed by preventable errors. There is a gap in the literature from the nurse's perspective as to why medical errors continue to occur despite having evidence-based safety strategies available. The purpose of this constructivist grounded theory study was to develop a theory explaining nurses' perception of their role in patient safety and why medical errors are still occurring despite implementation of evidence-based safety strategies. The systems engineering initiative for patient safety (SEIPS) model provided the conceptual framework for the study. Data collection included interviews with 11 nurses …

Amputee Social Support: A Quantitative Investigation Of Peer-To-Peer And Group Influence, Dirrick Anthony Williams

Walden Dissertations and Doctoral Studies

Previous research has indicated that vascular disease, trauma, and cancer lead to amputations and that 1.7 million Americans are living with an amputation. The social problem of this study is that amputees have limited places to obtain social support. Alderfer's Existence, Relatedness, and Growth Theory provided the foundation for this research. The current study examined the following questions. First, does type of social support impact amputee perceived social support satisfaction? Second, does type of social support impact life satisfaction? Survey methodology was used following attendance at either peer-to-peer or group support. A purposeful sample of 184 participants were assessed using …

An Assessment Of The Financial Literacy Of Undergraduates At One Community College In Texas, Melissa J. Weathersby

Walden Dissertations and Doctoral Studies

At a Texas community college, stakeholders wanted to strengthen the financial literacy module offered in the student development course for undergraduates. The problem was that no formative data existed on students' financial literacy, and it was not known if knowledge of financial literacy for students who participated in a prior financial literacy class in high school differed from students who had not. The purpose of this study was to obtain formative data regarding students' needs for financial literacy education and to examine whether the knowledge of financial literacy for college students who participated in a prior financial literacy class in …

Exploring Relationships Between Resilience, Thinking Styles, And Ptsd Scores In Women Veterans, Tanya Wilson

Walden Dissertations and Doctoral Studies

In 2013, military leadership took action to lift the ban on women participating in combat roles, thus creating a vital need to understand protective cognitive factors in women veterans exposed to combat. There is no prior research examining the relationship between resilience and thinking styles in this population. The purpose of this quantitative survey study was to examine the predictive relationship between resilience, measured with the Connor-Davidson Resilience Scale, and thinking styles, measured with the Thinking Styles Inventory-Revised 2, on posttraumatic stress disorder (PTSD) scores, measured by PCL-5, in women with combat exposure (CE). A cross-sectional design was used. A …

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright

Walden Dissertations and Doctoral Studies

Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …

Marketing Strategies Of International Pharmaceutical Companies In The Middle East And North Africa Region, Ali Abou Abbas

Walden Dissertations and Doctoral Studies

The declines in oil and gas prices in 2014 by 50% or more led governments in the Middle East and North Africa (MENA) region to decrease healthcare budgets correspondingly by more than 30%. The purpose of this multiple case study was to explore the marketing strategies that managers of international pharmaceutical companies have successfully implemented in the MENA region to ensure profitability after the 2014 decreases in the healthcare budgets, which followed the decline in oil and gas prices. The study involved data collection through semistructured interviews of 6 middle and executive managers working in 2 international pharmaceutical companies located …

Competence Of Behavioral Health Clinicians In Integrated Care Settings, Agyenim Akuamoah-Boateng

Walden Dissertations and Doctoral Studies

Collaborative efforts between medical and behavioral health professionals is required to simultaneously treat individuals with medical and mental health disorders. However, there is lack of focus on the competencies and trainings needed by behavioral health clinicians (BHCs) transitioning to integrated primary care (IPC) settings. The purpose of this qualitative interpretive phenomenological study was to describe the lived experiences of BHCs who have transitioned from specialty outpatient behavioral healthcare settings to IPC settings. Semi-structured interview questions were used to collect data. Using interpretive phenomenological data analysis approach, themes and the shared meanings and experiences of 8 licensed BHCs were explored. Seven …

Policy Implications And Perceptions Of African American Men Who Used Ritalin As Children, Divine Ayivor

Walden Dissertations and Doctoral Studies

Even though there are high diagnosis rates of ADHD among young African American

men, policy makers and parents have largely viewed the use of Ritalin as a psychotrop

ic

drug that raises public health concerns. African American parents may be reluctant to

treat their children pharmacologically. Very few studies have fully explored the

perceptions of African American men

about the consequences of their

Ritalin

use

as

chi

ldren. The purpose of this qualitative study was to explore the experiences of African

American men who used Ritalin as children

so that

policy makers

and

parents of children

with ADHD

might

better …

Procurement Total Cost Analysis: A Supply Chain Strategy For The Aviation Industry, Tulia S. Badillo

Walden Dissertations and Doctoral Studies

In the aviation industry, purchasing departments spend approximately 80% of revenues on procurement. Additionally, 62% of companies experience unforeseen expenses or hidden costs in the procurement process. Grounded in a conceptual framework of activity-based costing, the purpose of this case study was to explore strategies used by 5 upper-level supply chain management leaders at a maintenance repair and overhaul company in the aviation industry in the Southeastern United States to accurately forecast procurement costs. Data collection included 5 semistructured interviews, company documents, and annual reports. Through thematic analysis, the major themes that emerged from the data analysis were accuracy, competitive …

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …

Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean

Walden Dissertations and Doctoral Studies

Due to increased rates of childhood obesity since 2010, researchers have examined family environmental factors and family influences on children's consumption of healthy foods. While previous research has examined how factors such as food presentation and the food intake of other family members can predict a child's body mass index, there has been little research examining whether parent factors predict the amount of healthy foods children eat. This quantitative survey study examined whether certain parent factors, specifically parents' attitudes about food, parents' feeding styles, and parents' attachment styles, predicted the amount of fruits and vegetables children ate. Understanding the extent …

Student Perceptions Of E-Assessment Tools For Sign Language Interpretation, Marc Boese

Walden Dissertations and Doctoral Studies

American Sign Language (ASL) has grown to be the 3rd largest enrolled secondary language course in the United States, and colleges and universities seek to identify effective assessment methods for this visual-based language. Although much research exists on sign language e-learning programs, asynchronous video feedback, and sign recognition software, very few studies have been conducted on using technology to as a method of assessment for sign language courses. The purpose of this hermeneutical, phenomenological, qualitative study was to document the lived experiences of students using the electronic assessment tool, GoReact, in courses. The conceptual framework was guided by engagement theory …

The Effects Of Increased Emotional Intelligence On Information Technology Professionals, Reba Alexander Businsky

Walden Dissertations and Doctoral Studies

Information technology professionals effectively manage complex, tactical processes and procedures for internal and external customers. At the time of this study there was a gap in the literature regarding the effects of emotional intelligence on information technology professionals. An organization's internal and external customers may become dissatisfied with the information technology professionals because of their communication style lacking an increased level of emotional intelligence. The purpose of this quantitative study was to research the effects of increased emotional intelligence by surveying 315 information technology professionals. Data were collected using 3 electronic surveys including a general questionnaire to collect demographic data, …

Differentiating Theists And Nontheists By Way Of A Sampling Of Self-Reported Sexual Thoughts And Behaviors, Kelli Callahan

Walden Dissertations and Doctoral Studies

Numerous researchers have addressed the impact of individual religiosity or spirituality on psychological well-being. However, studies addressing the possible relationship between religiosity and sexuality, specifically in the form of deterrence of certain sexual thoughts or behaviors based upon religious dictates, remain sparse. Individual religiosity may be related to individual sexual self-expression. Built on the framework of cognitive-dissonance theory and self-determination theory, this quantitative, correlational study was designed to examine the relationships between religiosity and sexual attitudes and behaviors of both theist and nontheist population samples comprised of approximately 400 subjects throughout the United States. Study participants completed the Derogatis Sexual …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

The Relationship Between Body Dissatisfaction And Cosmetic Enhancement Surgery, Amanda Crandall Sharp

Walden Dissertations and Doctoral Studies

Previous research has indicated an increasing trend toward elective cosmetic surgery to achieve a perceived ideal body image and meet psychological and social needs. However, there remains a gap in the literature regarding the number of procedures performed on a single patient, and the potential that patients may suffer from body dysmorphic disorder (BDD). Therefore, the purpose of this quantitative study was to examine the relationship between the number of cosmetic surgeries undergone, level of body dissatisfaction, level of dysmorphic concern, and preoccupation with appearance. Participants included 75 females and 55 males, ranging in age from 18 to 64 years. …

Relational Aggression Among Adolescent African American Females, Latoshia S. Daniels

Walden Dissertations and Doctoral Studies

Relational aggression includes manipulative behaviors such as gossiping, spreading rumors, or practicing exclusion to intentionally destroy a peer's social reputation. Aggressive behaviors such as those found in relational aggression contribute to unsafe school environments. Research on relational aggression has increased in recent years, yet there is minimal research on relational aggression among African American adolescent females. The research questions were What is social workers' understanding of relational aggression? and How do social workers' cultural awareness and general understanding of African American females' relationships and interpersonal connections impact their ability to connect with their clients in the therapeutic relationship? The purpose …

Family, Community, And Peer Factors In Substance Abuse Recovery And School Achievement, Lisa Duszynski

Walden Dissertations and Doctoral Studies

Research correlates adolescent drug use and dropout rates, and the National Survey on Drug Use and Health shows 31.4% of those who dropped out of high school had used an illicit substance recently. The purpose of this study was to examine adolescents' perceptions of the influence of family, peers, and community, on recovery and academic achievement as a result of participation in a school-referred drug education program. To inspect the study purpose, Henggeler's multisystemic therapy was used to guide the study. Data collection used a researcher-designed, open-ended survey to collect responses from 14 individuals involved in a school-referred substance education …

Public Awareness Of Human Trafficking, Chelsea Annette Farrell

Walden Dissertations and Doctoral Studies

Public awareness is crucial in the fight against human trafficking, but little academic research looks at the public policy implications of different types of messaging the public may be using in recognizing human trafficking. Using policy feedback theory as the theoretical lens, the purpose of this quantitative study was to compare mean awareness scores for both film and social media to determine if there was a statistically significant difference between the scores and their degree of public awareness. Data were collected through an online survey, which included questions related to both film and social media, using a participant pool service. …

Type 2 Diabetes Management For Geriatric Veterans, Fachecia L. Fort

Walden Dissertations and Doctoral Studies

Managing diabetes in the geriatric long-term care population can be challenging, yet important because diabetes is a chronic, progressive disease. The purpose of this project was to identify clinical practice guidelines for managing Type 2 diabetes in geriatric veterans and to develop a class to educate providers on diabetes management in the geriatric long-term care population at a community living and rehabilitation center. The practice focused question asked if providing education to providers about the clinical practice guidelines for managing Type 2 diabetes in geriatric long-term care veterans would improve knowledge as measured by a pre- and posttest. The project …

Reentry Practitioners' Perceptions Of Constraints During Ex-Offenders' Job Search Process, Crystal Raquel Francis

Walden Dissertations and Doctoral Studies

Unemployment among formerly incarcerated citizens is a complex problem that continues to grow. Previous reentry studies describe the collateral effects of incarceration on employment from the perspective of formerly incarcerated individuals, yet little academic research exists regarding reentry practitioners' perceptions of constraints during the job search process. Using Goldratt's theory of constraints as the foundation, the purpose of this case study of reentry and employment in a mid-Atlantic state was to explore from the perspective of practitioners, the types of constraints individuals with criminal records face during the job search process, the most difficult phase of the job search process, …

Instructional Strategies That Homeschooling Parents Use To Teach Their Children Mathematics, Lisa Marie Francis

Walden Dissertations and Doctoral Studies

Homeschooling has become a viable educational choice for families; however, limited research has been conducted on the instructional strategies homeschooling parents use to instruct their children and whether these reflect a learner-centered teaching approach. The purpose of this qualitative case study was to explore the learner-centered instructional strategies homeschooling parents use to teach their children mathematics. The conceptual framework for this single-case study was based on Weimer's learner-centered teaching model. Participants included 4 parents who homeschooled students in Grades 6-12 in a Western state and who received instructional support from a private school. Data were collected from interviews with homeschooling …

Funding Allocations Strategies For Improving Nonprofit Organizations' Effectiveness And Sustainability, Jaime L. Friedel

Walden Dissertations and Doctoral Studies

Nonprofit organizational leaders (NOLs) face laws that require increased transparency and more oversight on funding allocations. Grounded by a conceptual framework of Hersey and Blanchard's situational leadership theory, Burns's transformational leadership theory, and Greenleaf's servant leadership theory, this multiple case study was developed to explore the leadership strategies of NOLs who implemented requirements of New York's Non-Profit Revitalization Act to increase funding allocations to support fulfillment of the organizational mission and achieve sustainability. The study population comprised NOLs from the Northeastern United States, who implemented requirements of the Non-Profit Revitalization Act requirements. Face-to-face semistructured interviews with 5 NOLs, a review …

Implementation Strategies For Quality Assurance Performance Improvements In Nursing Homes, Ameer Gilyard

Walden Dissertations and Doctoral Studies

The healthcare industry, and more specifically the nursing home sector, is changing operations and services due to a healthcare mandates and enactment of the 2010 Affordable Care Act. Such changes are termed quality assurance performance improvements (QAPI), to receive government subsidies and indemnification compensations. The purpose of this single case study was to explore effective strategies implemented by 4 healthcare leaders to comply with QAPI regulations. Total quality management theory was the conceptual framework used in this study. Data were collected through semistructured, open-ended, face-to-face interviews with 4 participants who serve in a management capacity at an organization located in …

Leadership Strategies To Improve Volunteer Retention, Rudene Pauline Glass

Walden Dissertations and Doctoral Studies

Nonprofit leaders face challenges retaining volunteers to support their organizations' human resources. The shortage of volunteers threatens nonprofit sustainability with increasing personnel cost for maintaining quality services. Grounded by Burns's transformational leadership theory, the purpose of this multiple case study was to explore strategies nonprofit leaders from southeastern Michigan used to improve volunteer retention. Data were collected through face-to-face semistructured interviews with 3 nonprofit leaders and a review of organizational documents such as volunteer implementation plans, strategic plans, and volunteer committee notes. Data were analyzed using a methodological triangulation process of sorting comments, which involved a chronological review of the …

The Predictability Of Facebook Memorial Page Participation On Grief, Colleen Grote

Walden Dissertations and Doctoral Studies

As the world's largest social networking site, Facebook, continues to grow in popularity, it is imperative for counselors and counselor educators to better understand how online environments impact all facets of life, including death. Grief behaviors on Facebook have been a focus of scholars since the launch of the social networking site in 2004. Researchers have demonstrated that Facebook memorial pages have a significant impact on the social and cultural practices related to death and memorialization for Facebook users. However, despite a rapid rise in research related to online mourning, researchers have yet been able to establish the potential risk …

Influence Of Privatization Policies On Residential Satisfaction In Military Family Housing, Kirsten R. Hawley

Walden Dissertations and Doctoral Studies

Little published research has examined the post-implementation outcomes of public private partnerships for housing, specifically the Military Privatized Housing Initiative (MPHI) from the perspective of the end user, the Military Family Housing (MFH) resident. Using Mettler and SoRelle's conceptualization of policy feedback theory as the foundation, the purpose of this repeated cross-sectional study was to assess residential satisfaction pre- and post- implementation of the MPHI. The study also addressed the influence of sociodemographic factors on MFH residents' perceived residential satisfaction. Secondary data were collected using 2 Department of Defense surveys administered pre- and post-implementation. An independent-samples t test was used …